Contrave Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Aetna Better Health - Anti-Obesity Agents Prior Authorization CriteriaAetna Better Health
Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Blue Cross Blue Shield of Minnesota - Weight Loss Agents Prior Authorization with Quantity LimitBlue Cross Blue Shield of Minnesota
Blue Cross Blue Shield of North Dakota - Restricted Use Drug ListBlue Cross Blue Shield of North Dakota
Blue Cross Complete - Medication Prior Authorization Request FormBlue Cross Complete
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.

ICD-10 codes for Contrave Prior Authorizations

E66.9Obesity, unspecified

Brand Resources

Pharmacy List Pharmacy List resource
Billing & Coding GuideBilling & Coding Guide resource
Prior Authorization ChecklistPrior Authorization Checklist resource

Support for Getting Your Patient on Contrave

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